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State Keeps Medicaid Expansion Study Secret

The state is keeping a tight lid on a study it commissioned last year on expanding Medicaid under the Affordable Care Act. The expansion would provide health care coverage to about 40,000 low income Alaskans. The federal government would pay most of the bill. Governor Sean Parnell has decided not to expand Medicaid, for now. The study it won’t release is meant to inform the Governor on whether to reconsider that position.

The Medicaid expansion study was supposed to be complete last December. In May, APRN filed a Freedom of Information Act request for the study. The state denied it.

Matt Buettgens is a senior research associate at the nonpartisan Urban Institute. He says it’s unusual for a state to be unwilling to share the Medicaid expansion study with the public.

“Certainly most states have commissioned such analyses and the vast majority of them have released them publicly,” Buettgens said.

The decision on whether to expand Medicaid is a huge one, with implications far beyond low income Alaskans. It would flood hospitals and providers with new revenue. Combined with other Affordable Care Act provisions, it would cut the number of Alaskans who are uninsured in half. And the expansion would pump hundreds of millions of federal dollars into the state. That’s according to a study Buettgens wrote on the Medicaid expansion that was commissioned by the Alaska Native Tribal Health Consortium. He says over the first five years of the expansion, a small amount of state spending would yield a lot of federal dollars.

“There would be about $78 million more state spending on Medicaid in Alaska and that would actually draw $1.1 billion additional federal spending. So the state would only be paying a small fraction of the total spending on Medicaid,” he said.

Buettgens says much of that state spending would be offset by savings to the state because some low income programs it currently administers would no longer be necessary.

The state won’t say if its own study agrees with the Urban Institute’s overall assessment.

Josh Applebee is the state’s deputy director for health care policy. He’s spending the majority of his work days reviewing the Medicaid expansion study and preparing a recommendation for Governor Sean Parnell. He says the study will be released when he finalizes that recommendation, in a few months. In the meantime, he says the decision making process would be compromised if the state released the study.

“When you get into different policy alternatives, you end up creating a chilling effect on candid policy debates that happen within governmental organizations,” Applebee said.

The study itself doesn’t contain any policy alternatives, only basic information on how the Medicaid expansion is likely to impact Alaska. But Applebee maintains it needs to stay private. He says the Governor’s decision may seem like an easy one, because of the huge amount of federal dollars involved, but it’s not.

“This is a decision that he wants to get right,” Applebee said. “So it’s being as thorough as we can with the data that we have, the reports that we have, the discussions we’re having among the divisions to get this decision right.”

“And to make our recommendation is the best possible one for the Governor.”

State Representative Andy Josephson, a Democrat from Anchorage, tried to rally support for the Medicaid expansion during this year’s legislative session. He didn’t find many lawmakers who were similarly passionate about the issue. Now he’s suggesting the Parnell administration could have something to hide.

“That undermines the democratic process and makes one wonder, what is it that the administration fears? What is it from the report that the administration is afraid to share with us?,” Josephson said.

Josephson introduced a resolution urging the Governor to expand Medicaid that got no traction in the legislature. He says with so much at stake, he wants to put pressure on Parnell to make the right decision. Governor Parnell has said his next “decision point” on Medicaid, as he puts it, will be when he sends his budget to the state legislature, which is required by December 15th.

This story is part of a reporting partnership between APRN, NPR and Kaiser Health News.

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